| Medical Avenue Internal Medicine Pc | |
|
1920 Medical Ave Ste F Harrisonburg VA 22801-8016 | |
| (540) 908-3095 | |
| (540) 908-3085 |
| Full Name | Medical Avenue Internal Medicine Pc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1920 Medical Ave, Harrisonburg, Virginia |
| Authorized Official Name and Position | Ilija Steven Rakaric (DIRECTOR / INCORPORATOR) |
| Authorized Official Contact | 5409083095 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Avenue Internal Medicine Pc 1920 Medical Ave Ste F Harrisonburg VA 22801-8016 Ph: (540) 908-3095 | Medical Avenue Internal Medicine Pc 1920 Medical Ave Ste F Harrisonburg VA 22801-8016 Ph: (540) 908-3095 |
| NPI Number | 1780079558 |
|---|---|
| Provider Enumeration Date | 03/30/2015 |
| Last Update Date | 04/20/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780079558 | NPI | - | NPPES |
| 1184734154 | Other | NPI | |
| 21467 | Other | OPTIMA HEALTH | |
| 006023169 | Medicaid | VA | |
| 211236 | Other | ANTHEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 0101054605 (Virginia) | Primary |
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